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Every day one sees politicians on TV assuring us that nuclear deterrence works because there no nuclear weapon has been exploded in anger since 1945. They clearly have no understanding of statistics.

With a few plausible assumptions, we can easily calculate that the time until the next bomb explodes could be as little as 20 years.

Be scared, very scared.

The first assumption is that bombs go off at random intervals. Since we have had only one so far (counting Hiroshima and Nagasaki as a single event), this can’t be verified. But given the large number of small influences that control when a bomb explodes (whether in war or by accident), it is the natural assumption to make. The assumption is given some credence by the observation that the intervals between wars are random [download pdf].

If the intervals between bombs are random, that implies that the distribution of the length of the intervals is exponential in shape, The nature of this distribution has already been explained in an earlier post about the random lengths of time for which a patient stays in an intensive care unit. If you haven’t come across an exponential distribution before, please look at that post before moving on.

All that we know is that 70 years have elapsed since the last bomb. so the interval until the next one must be greater than 70 years. The probability that a random interval is longer than 70 years can be found from the cumulative form of the exponential distribution.

If we denote the true mean interval between bombs as $\mu$ then the probability that an intervals is longer than 70 years is

$\text{Prob}\left( \text{interval > 70}\right)=\exp{\left(\frac{-70}{\mu_\mathrm{lo}}\right)}$

We can get a lower 95% confidence limit (call it $\mu_\mathrm{lo}$) for the mean interval between bombs by the argument used in Lecture on Biostatistics, section 7.8 (page 108). If we imagine that $\mu_\mathrm{lo}$ were the true mean, we want it to be such that there is a 2.5% chance that we observe an interval that is greater than 70 years. That is, we want to solve

$\exp{\left(\frac{-70}{\mu_\mathrm{lo}}\right)} = 0.025$

That’s easily solved by taking natural logs of both sides, giving

$\mu_\mathrm{lo} = \frac{-70}{\ln{\left(0.025\right)}}= 19.0\text{ years}$

A similar argument leads to an upper confidence limit, $\mu_\mathrm{hi}$, for the mean interval between bombs, by solving

$\exp{\left(\frac{-70}{\mu_\mathrm{hi}}\right)} = 0.975$
so
$\mu_\mathrm{hi} = \frac{-70}{\ln{\left(0.975\right)}}= 2765\text{ years}$

If the worst case were true, and the mean interval between bombs was 19 years. then the distribution of the time to the next bomb would have an exponential probability density function, $f(t)$,

 $f(t) = \frac{1}{19} \exp{\left(\frac{-70}{19}\right)}$ There would be a 50% chance that the waiting time until the next bomb would be less than the median of this distribution, =19 ln(0.5) = 13.2 years.

In summary, the observation that there has been no explosion for 70 years implies that the mean time until the next explosion lies (with 95% confidence) between 19 years and 2765 years. If it were 19 years, there would be a 50% chance that the waiting time to the next bomb could be less than 13.2 years. Thus there is no reason at all to think that nuclear deterrence works well enough to protect the world from incineration.

### Another approach

My statistical colleague, the ace probabilist Alan Hawkes, suggested a slightly different approach to the problem, via likelihood. The likelihood of a particular value of the interval between bombs is defined as the probability of making the observation(s), given a particular value of $\mu$. In this case, there is one observation, that the interval between bombs is more than 70 years. The likelihood, $L\left(\mu\right)$, of any specified value of $\mu$ is thus

$L\left(\mu\right)=\text{Prob}\left( \text{interval > 70 | }\mu\right) = \exp{\left(\frac{-70}{\mu}\right)}$

 If we plot this function (graph on right) shows that it increases with $\mu$ continuously, so the maximum likelihood estimate of $\mu$ is infinity. An infinite wait until the next bomb is perfect deterrence.

But again we need confidence limits for this. Since the upper limit is infinite, the appropriate thing to calculate is a one-sided lower 95% confidence limit. This is found by solving

$\exp{\left(\frac{-70}{\mu_\mathrm{lo}}\right)} = 0.05$

which gives

$\mu_\mathrm{lo} = \frac{-70}{\ln{\left(0.05\right)}}= 23.4\text{ years}$

Summary

The first approach gives 95% confidence limits for the average time until we get incinerated as 19 years to 2765 years. The second approach gives the lower limit as 23.4 years. There is no important difference between the two methods of calculation. This shows that the bland assurances of politicians that “nuclear deterrence works” is not justified.

It is not the purpose of this post to predict when the next bomb will explode, but rather to point out that the available information tells us very little about that question. This seems important to me because it contradicts directly the frequent assurances that deterrence works.

The only consolation is that, since I’m now 79, it’s unlikely that I’ll live long enough to see the conflagration.

Anyone younger than me would be advised to get off their backsides and do something about it, before you are destroyed by innumerate politicians.

Postscript

While talking about politicians and war it seems relevant to reproduce Peter Kennard’s powerful image of the Iraq war.

and with that, to quote the comment made by Tony Blair’s aide, Lance Price

It’s a bit like my feeling about priests doing the twelve stations of the cross. Politicians and priests masturbating at the expense of kids getting slaughtered (at a safe distance, of course).

### Follow-up

The Scottish Universities Medical Journal asked me to write about the regulation of alternative medicine. It’s an interesting topic and not easy to follow because of the veritable maze of more than twenty overlapping regulators and quangos which fail utterly to protect the public against health fraud. In fact they mostly promote health fraud. The paper is now published, and here is a version with embedded links (and some small updates).

We are witnessing an increasing commercialisation of medicine. It’s really taken off since the passage of the Health and Social Security Bill into law. Not only does that mean having NHS hospitals run by private companies, but it means that “any qualified provider” can bid for just about any service.  The problem lies, of course, in what you consider “qualified” to mean.  Any qualified homeopath or herbalist will, no doubt, be eligible.  University College London Hospital advertised for a spiritual healer. The "person specification" specified a "quallfication", but only HR people think that a paper qualification means that spiritual healing is anything but a delusion.

### The vocabulary of bait and switch

First, a bit of vocabulary.  Alternative medicine is a term that is used for medical treatments that don’t work (or at least haven’t been shown to work).  If they worked, they’d be called “medicine”.  The anti-malarial, artemesinin, came originally from a Chinese herb, but once it had been purified and properly tested, it was no longer alternative.  But the word alternative is not favoured by quacks.  They prefer their nostrums to be described as “complementary” –it sounds more respectable.  So CAM (complementary and alternative medicine became the politically-correct euphemism.  Now it has gone a stage further, and the euphemism in vogue with quacks at the moment is “integrated” or “integrative” medicine.  That means, very often, integrating things that don’t work with things that do.  But it sounds fashionable.  In reality it is designed to confuse politicians who ask for, say, integrated services for old people.

Put another way, the salespeople of quackery have become rather good at bait and switch. The wikepedia definition is as good as any.

Bait-and-switch is a form of fraud, most commonly used in retail sales but also applicable to other contexts. First, customers are “baited” by advertising for a product or service at a low price; second, the customers discover that the advertised good is not available and are “switched” to a costlier product.

As applied to the alternative medicine industry, the bait is usually in the form of some nice touchy-feely stuff which barely mentions the mystical nonsense. But when you’ve bought into it you get the whole panoply of nonsense. Steven Novella has written eloquently about the use of bait and switch in the USA to sell chiropractic, acupuncture, homeopathy and herbal medicine: "The bait is that CAM offers legitimate alternatives, the switch is that it primarily promotes treatments that don’t work or are at best untested and highly implausible.".

The "College of Medicine" provides a near-perfect example of bait and switch. It is the direct successor of the Prince of Wales’ Foundation for Integrated Health. The Prince’s Foundation was a consistent purveyor of dangerous medical myths. When it collapsed in 2010 because of a financial scandal, a company was formed called "The College for Integrated Health". A slide show, not meant for public consumption, said "The College represents a new strategy to take forward the vision of HRH Prince Charles". But it seems that too many people have now tumbled to the idea that "integrated", in this context, means barmpottery. Within less than a month, the new institution was renamed "The College of Medicine". That might be a deceptive name, but it’s a much better bait. That’s why I described the College as a fraud and delusion.

Not only did the directors, all of them quacks, devise a respectable sounding name, but they also succeeded in recruiting some respectable-sounding people to act as figureheads for the new organisation. The president of the College is Professor Sir Graham Catto, emeritus professor of medicine at the University of Aberdeen. Names like his make the bait sound even more plausible. He claims not to believe that homeopathy works, but seems quite happy to have a homeopathic pharmacist, Christine Glover, on the governing council of his college. At least half of the governing Council can safely be classified as quacks.

So the bait is clear. What about the switch? The first thing to notice is that the whole outfit is skewed towards private medicine: see The College of Medicine is in the pocket of Crapita Capita. The founder, and presumably the main provider of funds (they won’t say how much) is the huge outsourcing company, Capita. This is company known in Private Eye as Crapita. Their inefficiency is legendary. They are the folks who messed up the NHS computer system and the courts computer system. After swallowing large amounts of taxpayers’ money, they failed to deliver anything that worked. Their latest failure is the court translation service.. The president (Catto), the vice president (Harry Brunjes) and the CEO (Mark Ratnarajah) are all employees of Capita.

The second thing to notice is that their conferences and courses are a bizarre mixture of real medicine and pure quackery. Their 2012 conference had some very good speakers, but then it had a "herbal workshop" with Simon Mills (see a video) and David Peters (the man who tolerates dowsing as a way to diagnose which herb to give you). The other speaker was Dick Middleton, who represents the huge herbal company, Schwabe (I debated with him on BBC Breakfast), In fact the College’s Faculty of Self-care appears to resemble a marketing device for Schwabe.

### Why regulation isn’t working, and can’t work

There are various levels of regulation. The "highest" level is the statutory regulation of osteopathy and chiropractic. The General Chiropractic Council (GCC) has exactly the same legal status as the General Medical Council (GMC). This ludicrous state of affairs arose because nobody in John Major’s government had enough scientific knowledge to realise that chiropractic, and some parts of osteopathy, are pure quackery,

The problem is that organisations like the GCC function more to promote chiropractic than to regulate them. This became very obvious when the British Chiropractic Association (BCA) decided to sue Simon Singh for defamation, after he described some of their treatments as “bogus”, “without a jot of evidence”.

In order to support Singh, several bloggers assessed the "plethora of evidence" which the BCA said could be used to justify their claims. When, 15 months later, the BCA produced its "plethora" it was shown within 24 hours that the evidence was pathetic. The demolition was summarised by lawyer, David Allen Green, in The BCA’s Worst Day.

In the wake of this, over 600 complaints were made to the GCC about unjustified claims made by chiropractors, thanks in large part to heroic work by two people, Simon Perry and Allan Henness. Simon Perry’s Fishbarrel (browser plugin) allows complaints to be made quickly and easily -try it). The majority of these complaints were rejected by the GCC, apparently on the grounds that chiropractors could not be blamed because the false claims had been endorsed by the GCC itself.

My own complaint was based on phone calls to two chiropractors, I was told such nonsense as "colic is down to, er um, faulty movement patterns in the spine". But my complaint  never reached the Conduct and Competence committee because it had been judged by a preliminary investigating committee that there was no case to answer. The impression one got from this (very costly) exercise was that the GCC was there to protect chiropractors, not to protect the public.

The outcome was a disaster for chiropractors, wno emerged totally discredited. It was also a disaster for the GCC which was forced to admit that it hadn’t properly advised chiropractors about what they could and couldn’t claim. The recantation culminated in the GCC declaring, in August 2010, that the mythical "subluxation" is a "historical concept " "It is not supported by any clinical research evidence that would allow claims to be made that it is the cause of disease.". Subluxation was a product of the fevered imagination of the founder of the chiropractic cult, D.D. Palmer. It referred to an imaginary spinal lesion that he claimed to be the cause of most diseases. .Since ‘subluxation’ is the only thing that’s distinguished chiropractic from any other sort of manipulation, the admission by the GCC that it does not exist, after a century of pretending that it does, is quite an admission.

The President of the BCA himself admitted in November 2011

“The BCA sued Simon Singh personally for libel. In doing so, the BCA began one of the darkest periods in its history; one that was ultimately to cost it financially,”

As a result of all this, the deficiencies of chiropractic, and the deficiencies of its regulator were revealed, and advertisements for chiropractic are somewhat less misleading. But this change for the better was brought about entirely by the unpaid efforts of bloggers and a few journalists, and not at all by the official regulator, the GCC. which was part of the problem. not the solution. And it was certainly not helped by the organisation that is meant to regulate the GCC, the Council for Health Regulatory Excellence (CHRE) which did nothing whatsoever to stop the farce.

At the other end of the regulatory spectrum, voluntary self-regulation, is an even worse farce than the GCC. They all have grand sounding "Codes of Practice" which, in practice, the ignore totally.

The Society of Homeopaths is just a joke. When homeopaths were caught out recommending sugar pills for prevention of malaria, they did nothing (arguably such homicidal advice deserves a jail sentence).

The Complementary and Natural Healthcare Council (CNHC) is widely know in the blogosphere as Ofquack. I know about them from the inside, having been a member of their Conduct and Competence Committee, It was set up with the help of a £900,000 grant from the Department of Health to the Prince of Wales, to oversee voluntary self-regulation. It fails utterly to do anything useful.. The CNHC code of practice, paragraph 15 , states

When Simon Perry made a complaint to the CNHC about claims being made by a CNHC-registered reflexologist, the Investigating Committee upheld all 15 complaints.  But it then went on to say that there was no case to answer because the unjustified claims were what the person had been taught, and were made in good faith.
This is precisely the ludicrous situation which will occur again and again if reflexologists (and many other alternative therapies) are “accredited”.  The CNHC said, correctly, that the reflexologist had been taught things that were not true, but then did nothing whatsoever about it apart from toning down the advertisements a bit. They still register reflexologists who make outrageously false claims.

Once again we see that no sensible regulation is possible for subjects that are pure make-believe.

The first two examples deal (or rather, fail to deal) with regulation of outright quackery. But there are dozens of other quangos that sound a lot more respectable.

European Food Standards Agency (EFSA). One of the common scams is to have have your favourite quack treatment classified as a food not as a medicine. The laws about what you can claim have been a lot laxer for foods. But the EFSA has done a pretty good job in stopping unjustified claims for health benefits from foods. Dozens of claims made by makers of probiotics have been banned. The food industry, needless to say, objects very strongly to be being forced to tell the truth. In my view, the ESFA has not gone far enough. They recently issued a directive about claims that could legally be made. Some of these betray the previously high standards of the EFSA. For example you are allowed to say that "Vitamin C contributes to the reduction of tiredness and fatigue" (as long as the product contains above a specified amount of Vitamin C. I’m not aware of any trials that show vitamin C has the slightest effect on tiredness or fatigue, Although these laws do not come into effect until December 2012, they have already been invoked by the ASA has a reason not to uphold a complaint about a multivitamin pill which claimed that it “Includes 8 nutrients that can contribute to the reduction in tiredness and fatigue”

The Advertising Standards Authority (ASA). This is almost the only organisation that has done a good job on false health claims. Their Guidance on Health Therapies & Evidence says

"Whether you use the words ‘treatment’, ‘treat’ or ‘cure’, all are likely to be seen by members of the public as claims to alleviate effectively a condition or symptom. We would advise that they are not used"

"Before and after’ studies with little or no control, studies without human subjects, self-assessment studies and anecdotal evidence are unlikely to be considered acceptable"

"Before and after’ studies with little or no control, studies without human subjects, self-assessment studies and anecdotal evidence are unlikely to be considered acceptable"

They are spot on.

The ASA’s Guidance for Advertisers of Homeopathic Services is wonderful.

"In the simplest terms, you should avoid using efficacy claims, whether implied or direct,"

"To date, the ASA has have not seen persuasive evidence to support claims that homeopathy can treat, cure or relieve specific conditions or symptoms."

That seems to condemn the (mis)labelling allowed by the MHRA as breaking the rules.. Sadly, though, the ASA has no powers to enforce its decisions and only too often they are ignored. The Nightingale collaboration has produced an excellent letter that you can hand to any pharmacist who breaks the rules

The ASA has also judged against claims made by "Craniosacral therapists" (that’s the lunatic fringe of osteopathy). They will presumably uphold complaints about similar claims made (I’m ashamed to say) by UCLH Hospitals.

The private examination company Edexcel sets exams in antiscientific subjects, so miseducating children. The teaching of quackery to 16 year-olds has been approved by a maze of quangos, none  of which will take responsibility, or justify their actions. So far I’ve located no fewer than eight of them. The Office of the Qualifications and Examinations Regulator (OfQual), Edexcel, the Qualifications and Curriculum Authority (QCA), Skills for Health, Skills for Care, National Occupational Standards (NOS), private exam company VTCT and the schools inspectorate, Ofsted.. Asking any of these people why they approve of examinations in imaginary subjects meets with blank incomprehension. They fail totally to protect tha public from utter nonsense.

The Department of Education has failed to do anything about the miseducation of children in quackery. In fact it has encouraged it by, for the first time, giving taxpayers’ money to a Steiner (Waldorf) school (at Frome, in Somerset). Steiner schools are run by a secretive and cult-like body of people (read about it). They teach about reincarnation, karma, gnomes, and all manner of nonsense, sometimes with unpleasant racial overtones. The teachers are trained in Steiner’s Anthroposophy, so if your child gets ill at school they’ll probably get homeopathic sugar pills. They might well get measles or mumps too, since Steiner people don’t believe in vaccination.

Incredibly, the University of Aberdeen came perilously close to appointing a chair in anthroposophical medicine. This disaster was aborted by bloggers, and a last minute intervention from journalists. Neither the university’s regulatory mechanisms. nor any others, seemed to realise that a chair in mystical barmpottery was a bad idea.

It is the statutory duty of Trading Standards to enforce the Consumer Protection Regulations (2008) This European legislation is pretty good. it caused a lawyer to write " Has The UK Quietly Outlawed “Alternative” Medicine?". Unfortunately Trading Standards people have consistently refused to enforce these laws. The whole organisation is a mess. Its local office arrangement fails totally to deal with the age of the internet. The situation is so bad that a group of us decided to put them to the test. The results were published in the Medico-Legal Journal, Rose et al., 2012. "Spurious Claims for Health-care Products: An Experimental Approach to Evaluating Current UK Legislation and its Implementation". They concluded "EU directive 2005/29/EC is
largely ineffective in preventing misleading health claims for consumer products in
the UK"

Skills for Health is an enormous quango which produces HR style "competences" for everything under the son. They are mostly quite useless. But those concerned with alternative medicine are not just useless. They are positively harmful. Totally barmy. There are competences and National Occupational Standards for every lunatic made-up therapy under the sun. When I phoned them to discover who’d written them, I learned that the had been drafted by the Prince of Wales’ Foundation for Magic Medicine. And when I joked by asking if they had a competence for talking to trees, I was told, perfectly seriously, “You’d have to talk to LANTRA, the land-based organisation for that.”

That was in January 2008. A lot of correspondence with the head of Skills for Health got nowhere at all. She understood nothing and it hasn’t improved a jot.

This organisation costs a lot of taxpayers’ money and it should have been consigned to the "bonfire of the quangos" (but of course there was no such bonfire in reality). It is a disgrace.

The Quality Assurance Agency (QAA) is supposed to ensure the quality of university courses. In fact it endorses courses in nonsense alternative medicine and so does more harm than good. The worst recent failure of the QAA was in the case of the University of Wales: see Scandal of the University of Wales and the Quality Assurance Agency. The university was making money by validating thousands of external degrees in everything from fundamentalist theology to Chinese Medicine. These validations were revealed as utterly incompetent by bloggers, and later by BBC Wales journalist Ciaran Jenkins (now working for Channel 4).

The mainstream media eventually caught up with bloggers. In 2010, BBC1 TV (Wales) produced an excellent TV programme that exposed the enormous degree validation scam run by the University of Wales. The programme can be seen on YouTube (Part 1, and Part 2). The programme also exposed, incidentally, the uselessness of the Quality Assurance Agency (QAA) which did nothing until the scam was exposed by TV and blogs. Eventually the QAA sent nine people to Malaysia to investigate a dodgy college that had been revealed by the BBC. The trip cost £91,000. It could have been done for nothing if anyone at the QAA knew how to use Google.

The outcome was that the University of Wales stopped endorsing external courses, and it was soon shut down altogether (though bafflingly, its vice-chancellor, Marc Clement was promoted). The credit for this lies entirely with bloggers and the BBC. The QAA did nothing to help until the very last moment.

Throughout this saga Universities UK (UUK), has maintained its usual total passivity. They have done nothing whatsoever about their members who give BSc degrees in anti-scientific subjects. (UUK used to known as the Committee of Vice-Chancellors and Principals).

Council for Health Regulatory Excellence (CHRE), soon to become the PSAHSC,

Back now to the CHRE, the people who failed so signally to sort out the GCC. They are being reorganised. Their consultation document says

"The Health and Social Care Act 20122 confers a new function on the Professional Standards Authority for Health and Social Care (the renamed Council for Healthcare Regulatory Excellence). From November 2012 we will set standards for organisations that hold voluntary registers for people working in health and social care occupations and we will accredit the register if they meet those standards. It will then be known as an ‘Accredited Register’. "

They are trying to decide what the criteria should be for "accreditation" of a regulatory body. The list of those interested has some perfectly respectable organisations, like the British Psychological Society. It also contains a large number of crackpot organisations, like Crystal and Healing International, as well as joke regulators like the CNHC.

They already oversee the Health Professions Council (HPC) which is due to take over Herbal medicine and Traditional Chinese Medicine, with predictably disastrous consequences.

Two of the proposed criteria for "accreditation" appear to be directly contradictory.

Para 2.5 makes the whole accreditation pointless from the point of view of patients

2.5 It will not be an endorsement of the therapeutic validity or effectiveness of any particular discipline or treatment.

Since the only thing that matters to the patient is whether the therapy works (and is safe), accrediting of organisations that ignore this will merely give the appearance of official approval of crystal healing etc etc. This appears to contradict directly

A.7 The organisation can demonstrate that there either is a sound knowledge base underpinning the profession or it is developing one and makes that explicit to the public.

A "sound knowledge base", if it is to mean anything useful at all, means knowledge that the treatment is effective. If it doesn’t mean that, what does it mean?

It seems that the official mind has still not grasped the obvious fact that there can be no sensible regulation of subjects that are untrue nonsense. If it is nonsense, the only form of regulation that makes any sense is the law.

Please fill in the consultation. My completed return can be downloaded as an example, if you wish.

Medicines and Healthcare products Regulatory Agency (MHRA) should be a top level defender of truth. Its strapline is

"We enhance and safeguard the health of the public by ensuring that medicines and medical devices work and are acceptably safe."

The MHRA did something (they won’t tell me exactly what) about one of the most cruel scams that I’ve ever encountered, Esperanza Homeopathic Neuropeptide, peddled for multiple sclerosis, at an outrageous price ( £6,759 for 12 month’s supply). Needless to say there was not a jot of evidence that it worked (and it wasn’t actually homeopathic).

The MHRA admit (when pushed really hard) that there is precious little evidence that any of the herbs work, and that homeopathy is nothing more than sugar pills. Their answer to that is to forget that bit about "ensuring that medicines … work"

Here’s the MHRA’s Traditional Herbal Registration Certificate for devils claw tablets.

The wording "based on traditional use only" has to be included because of European legislation. Shockingly, the MHRA have allowed them to relegate that to small print, with all the emphasis on the alleged indications. The pro-CAM agency NCCAM rates devil’s claw as "possibly effective" or "insufficient evidence" for all these indications, but that doesn’t matter because the MHRA requires no evidence whatsoever that the tablets do anything. They should, of course, added a statement to this effect to the label. They have failed in their duty to protect and inform the public by allowing this labelling.

But it gets worse. Here is the MHRA’s homeopathic marketing authorisation for the homeopathic medicinal product Arnicare Arnica 30c pillules

It is nothing short of surreal.

Since the pills contain nothing at all, they don’t have the slightest effect on sprains, muscular aches or bruising. The wording on the label is exceedingly misleading.

If you "pregnant or breastfeeding" there is no need to waste you doctor’s time before swallowing a few sugar pills.

"Do not take a double dose to make up for a missed one". Since the pills contain nothing, it doesn’t matter a damn.

"If you overdose . . " it won’t have the slightest effect because there is nothing in them

And it gets worse. The MHRA-approved label specifies ACTIVE INGREDIENT. Each pillule contains 30c Arnica Montana

No, they contain no arnica whatsoever.

It truly boggles the mind that men with dark suits and lots of letters after their names have sat for hours only to produce dishonest and misleading labels like these.

When this mislabeling was first allowed, it was condemned by just about every scientific society, but the MHRA did nothing.

### The Nightingale Collaboration.

This is an excellent organisation, set up by two very smart skeptics, Alan Henness and Maria MacLachlan. Visit their site regularly, sign up for their newsletter Help with their campaigns. Make a difference.

### Conclusions

The regulation of alternative medicine in the UK is a farce. It is utterly ineffective in preventing deception of patients.

Such improvements as have occurred have resulted from the activity of bloggers, and sometime the mainstream media. All the official regulators have, to varying extents, made things worse.

The CHRE proposals promise to make matters still worse by offering "accreditation" to organisations that promote nonsensical quackery. None of the official regulators seem to be able to grasp the obvious fact that is impossible to have any sensible regulation of people who promote nonsensical untruths. One gets the impression that politicians are more concerned to protect the homeopathic (etc, etc) industry than they are to protect patients.

Deception by advocates of alternative medicine harms patients. There are adequate laws that make such deception illegal, but they are not being enforced. The CHRE and its successor should restrict themselves to real medicine. The money that they spend on pseudo-regulation of quacks should be transferred to the MHRA or a reformed Trading Standards organisation so they can afford to investigate and prosecute breaches of the law. That is the only form of regulation that makes sense.

### Follow-up

The shocking case of the continuing sale of “homeopathic vaccines” for meningitis, rubella, pertussis etc was highlighted in an excellent TV programme by BBC South West. The failure of the MHRA and the GPC do take any effective action is a yet another illustration of the failure of regulators to do their job. I have to agree with Andy Lewis when he concludes

“Children will die. And the fault must lie with Professor Sir Kent Woods, chairman of the regulator.”

We hear a lot about lifelong education, and a good thing too. But we have a government that seems to think life ends at 18. The contrast between official attitudes to schools and post-school education is striking. The contrast is most striking in two areas: religious discrimination and public support for costs.

Religous discriminatiion and selection

The Universities Tests Act was passed on 18 June 1871, while William Gladstone (Liberal) was Prime minister. It was "An Act to alter the law respecting Religious Tests in the Universities of Oxford, Cambridge, and Durham, and in the Halls and Colleges of those Universities". Of course UCL was founded in 1826, partly as a place that was free of religious discrimination. Since 1871 it has been illegal for a university to discriminate among applicants on the basis of their religious beliefs or lack of them. For the last 140 years it has been unimaginable that anyone would try to do such a thing.

In stark contrast, in 2010, religious discrimination among entrance to primary and secondary schools is not only legal, but is actively encouraged by the government. It was a trend that got worse while the ‘reverend’ Tony Blair (illiberal) was prime minister. The minister of education under the new conservative regime promised even more religious schools.

Why the rules should be diametrically opposite when you are younger than 18 from when you are over 18 is baffling.

It is equally baffling (and perhaps a partial explanation) that universities are not regarded by this government, or by Blair’s, as part of education at all. They are governed by the Department of Business, not the Department of Education.

Why should a postman pay for your university education?

I imagine that I’m not the only person who has wrestled with this question in the last few weeks (Stephen Law’s thoughts here)

In the UK it is a legal requirement to stay in full time education until the age of 16, and that should be increased to 18 by 2015. Although most children stay in school until 18, around 25% or 30% don’t. I have never heard anybody question the idea that education from 16 to 18 should not be supported 100 percent by the state, out of general taxation. That is the case despite the fact that not everybody stays in education up to 18.

Education up to the age of 18 is regarded as a common good and nobody questions for a moment that it should be free at the point of use.

Once again, everything changes entirely when you reach 18. Education is not regarded as a continuum, or as a life-long project. Suddenly at the age of 18, it stops being a public good worthy of state support, and becomes an optional extra for those who are rich, or those who are not deterred by the idea of going though life paying a debt that will, in some cases, approach the size of the mortgage on their house.

The ConDem coalition, on December 9th 2010, has come very close to privatising the teaching of humanities in universities. You are encouraged to learn languages from 16 – 18 and then these are dropped like a hot cake.

The result has been riots by schoolchildren and total discrediting of Liberal democrats who voted for one of the most philistine measures in living memory.

The discussion of this legislation has, in my view, focussed on the wrong thing. It has been almost entirely about the mechanisms for paying off an enormous debt. That was the wrong place to start. This is what should have been done.

(1) Consider what is being funded. Should the university system adapt to present circumstances, e.g by abolishing honours degrees and creating real graduate schools, as I suggested recently in the Times?   Disgracefully, the government has rushed headlong into changes in funding without waiting to consider what it should be funding. Equally disgracefuly, Universities UK (the vice-chancellors’ trade union) has made no constructive suggestions for change, but appears to be rendered immobile by a rift between the Russell group VCs who want to grab as much as they can as soon as possible, and other VCs who fear for their existence.

(2) After deciding what form universities should have in the future, you can then go on to discuss how much public money should be used to support the system.

(3) Only after both of these have been done, does it make sense to talk about how you pay back any contribution made by the student (and that contribution should be, at most, no bigger than now).

In their haste to make people pay high fees, the government seems to have got the worst of both worlds. They have devised a scheme that, in the long run, is likely to cost the taxpayer as much as, or even more than, the present system, while at the same time trebling fees to students. It’s hard to imagine greater incompetence than that.

But the question still lurks: why should a postman pay for your university education? My answer is yes, but not much. They should pay because, although they may not get any direct benefit themselves, their children certainly may. The fairest, most progressive, tax is income tax. If you are a postman, or indeed a graduate, on a low income you shouldn’t pay much tax, so you won’t pay much for, inter alia, other people’s university education.

I can see no reason for the sudden change in attitude to, and funding of, education that happens when you reach 18.

I see every reason why kids should be angry. I doubt that we have seen the last of the riots.

I hope not anyway.

### Follow-up

See also UCL’s Beautiful Occupation. Students seem to think more clearly about what’s happening than either university management or the government.

December 10 2010, The New York Times points out that tuition fees in the UK will, under this scheme, be double those of public universities in the USA."this new policy is an utter failure."

December 11 2010. An NHS doctor writes

"I was slightly dissapointed when 7/8 of my first year medical students showed up for their last day of teaching at my practice on thursday December 9th. The eighth student was ill, so not one of them was protesting. When I asked them why not they said that in their first week as medical students they were told not to get involved in any protests because even a police caution would mean they might be thrown off the course and almost certainly they wouldn’t get a job. Images of Fascist Spain or Nazi Germany came immediately to mind (I have just read Alone in Berlin)"

December 11 2010. The Guardian reports:

Liberal Democrat grassroots hit back over tuition fees
Richard Grayson, former director of policy, says Liberal Democrats should move closer to Ed Miliband and Labour

That sounds better.

December 12 2010. The Observer reports:
“Police officers ‘tried to stop hospital staff treating injured protester’ Mother of injured student Alfie Meadows said that her son’s life could have been put at risk by the journey to another hospital”.

The press may like to portray students as irresponsible and revolting . When I visited the occupied Jeremy Bentham room last week, i got a very different impression. That was more than confirmed yesterday (29 November). The students aren’t just sitting around grumbling. They have organised a very impressive series of events. Here is yesterday’s programme.

 I volunteered to discuss with them some ideas of what could be done to further their aims. It was the same day that our letter came out in the Daily Telegraph, that pointed out the foolishness of deciding on funding before deciding what form universities should have in the future, I also suggested some possible changes along the lines of those proposed in the Times in October.

I didn’t talk for long and the discussion that followed was lively and constructive. It was about education, not revolt.

I was asked if I’d like to come back a bit later for group discussions, so I did. I found the students had split into groups. It could well have been an academic conference.

There was a cheerful but entirely serious discussion about what universities should be doing, about teaching methods and about research. There was also discussion about how the good atmosphere could be continued when the occupation eventually ends. Perhaps the most obvious thing is that the students were enjoying immensely being thrown together with people from other disciplines, whom they would never have met otherwise. There were two scientists in the group I joined, the rest being from a whole range of disciplines.

It is to the credit of UCL that they haven’t brought in bailiffs or cut off access to toilets. So a lot more sensible than Warwick university’s management for example. An email was shown on the screen from Rex Knight, vice provost (operations) who seems to have been put in charge of mediation. He’s the one who refused to do anything about it when HR were advertising for people trained in that curious form of psychobabble/pyramid selling scheme, neurolinguistic programming. He decined to meet the students. These days, you just can’t get the staff.

You can just walk in and out of the Jeremy Bentham room quite freely. Some students left for lectures and then returned. Others were away that afternoon on a demonstration outside TopShop on Oxford Street. If people like Top Shop owner Philip Green paid the taxes that they should do, the crisis might not be as bad as it is.

And between the earnest intellectual stuff they have fun too. This is the dance-off against the Oxford occupation.

And this is their weekend Ceilidh

Their blog is impressive. as is their organisation. They they have an events organiser with their own email address. You can follow the activities on Twitter @ucloccupation. In just a few days they have picked up more followers on Twitter than I have,

Even the BBC reporter, Sean Coughlan, sees this a something a bit different.

These are well-dressed, articulate youngsters, there’s no damage to the room, and the occupation leaflets are mixed up with sleeping bags and text books about biology and Spanish grammar.

This looks like a revolution that probably does the hoovering when it’s finished. Any stereotypes about rent-a-rioter are way off the mark.

,

It’s the Hogwarts kids, with their strong sense of right and wrong, who are now putting up the barricades.

And they seem as distant from the old left as they do from the new right.

This could be the best educational experience of the year for some of them, and they were making the most of it.

It is really rather beautiful.

### Follow-up

Sad to say. UCL’s management soon managed to lose the moral high ground and went to court to evict the students. Their blog says

On Friday 3rd December two students on behalf of the UCL Occupations attended a hearing to resist the university’s application for a possession order. After almost an hour of legal debate, the judge acknowledged the occupying students’ rights to freedom of expression and freedom of assembly and concluded that no possession order could be granted without a full hearing of all the legal arguments. The hearing has been adjourned till Tuesday 7th December at 10:30am.

6 December 2010.Hobbled into work, for hospital appointment. The Slade School of Art is now occupied too. The signs are quite, eh, artistic.

Vince Cable, the Secretary of State for Business, Innovation and Skills, said on the Radio 4 Today programme on September 8th 2010

“There was some estimate on the basis of surveys done recently that something in the order of 45 per cent of the research grants that were going through was to research that was not of excellent standard. So the bar will have to be raised.”

The suggestion that 45 percent of research is mediocre provoked a storm, first on Twitter, than in blogs. One of the earlier blogs was In one day, Vince Cable has become an object of ridicule and loathing  Those that followed were scarcely more flattering. The number he quoted was simply wrong.

Unravelling Cable says "when the text of the speech was released, I was shocked by what it revealed about the Secretary of State’s grasp of his brief.".

A legion of people have tried to decode what he meant. The purpose of this post is to go a bit further, to investigate the problem of mediocre research and to suggest a change of policy that might help.

This appears to be what Cable should have said.

(1) His comments don’t refer to the main source of money for research at all. They refer to "quality-related" (QR) money given to universities by the Higher Education Finding Council. It is intended to support the infrastructure for support, but it vanishes into the ever-expanding administration and most researchers don’t see a penny of it.

(2) QR money is not given to individual researchers to do research, it is given to the university retrospectively, on the basis of the score in a vast, time-consuming, assessment known as the Research Assessment exercise. This grades departments on the basis of the amount of grade 1 2 3 or 4 research they do.

(3) Cable’s comment . on the BBC Radio 4 Today Programme that  “45% of research grants were not of excellent standard", caused uproar, and rightly so, because it shows a total lack of grasp of how science is funded, The "45%" doesn’t refer to grants at all, but it is the percentage of work that was judged in the RAE to be grade 1 or 2 (less good) rather than 3 or 4 (very good).

(4) Work that is graded 2 gets little QR money, and 1 gets none at all. David Sweeney, a HEFCE bureaucrat not generally noted for his understanding of research, points out that the 45 percent of 1 and 2 work gets only 7 percent of the funds. Using Cable’s criterion his number should have been 7% not 45%.

(5) In physics at least, the RAE panel claims it was told to use norm-referencing. This means that they are told roughly what fractions 3 and 4 grades to produce. HEFCE deny this is the case, but it is quite usual for big organisations to lie about this sort of thing. Insofar as norm-referencing was imposed, the fraction of research that is labelled mediocre is pre-determined, and is quite independent of quality. It means no more than saying that half the people are below average. It is just a statistical inevitability (if the distribution is symmetrical). It tells you absolutely nothing about the quality of research,

(6) A figure far more important than any of these is that only 10 – 20% of research grant applications get funded. It takes a long time to write a research grant application, something like two months. That is a major time-consuming activity for scientists, who should be thinking about science and doing experiments. Around 85% of that effort is fruitless. The cost in salaries and lost output of writing grants that fail is enormous. Being high alpha rated is certainly no guarantee of getting funds. That is the number that Cable should have produced, but didn’t.

### So what did Cable get right, and why?

This is the bit that hasn’t been discussed much in the comments so far.

If it so hard to get a grant, why is there a widespread perception that quite a lot of published work is, if not wrong, at least trivial?

(1) Most work has always been trivial. Great breakthroughs are very rare events. But let’s accept, for the sake of argument, that the widespread view that it is worse now that in used to be, or at least that quality hasn’t improved.

(2) There is now enormously more research than before. That means more top-rate work, but, perhaps, even more bad or trivial work

(3) The Research Assessment Exercise (RAE) is on of the main reasons why the fraction of good papers is perceived to have decreased. It has probably done more harm to research standards than any other single change in my lifetime.

(4) Although it is tempting to blame politicians for the harm done by the RAE, the greatest harm is actually done by senior academics and other ex-researchers, and their numerous administrative hangers-on, who apply intolerable pressure on their juniors to publish large numbers of papers, preferably in one of three ‘top’ journals. This inevitably leads to large numbers of trivial papers being produced, because people think they won’t be promoted if the don’t go along with the senior bullies,

(5) The fate of young researchers is made even worse by HR’s attempts at "well-being" (major post coming up on that topic), the money wasted on ‘Roberts agenda’ skills training and the utterly vacuous Concordat

(6) A consequence of this sort of pressure is that anyone who wants to think deeply, or to understand properly, the basis of what they are doing, is quite likely to be fired for lack of "productivity" before they produce their best work (I speak here of biomedical sciences. I presume that physicists can’t get way so easily with poor understanding of principles of their subject).

(7) The result is a system that is not just over-competitive, but positively cruel to young scientists. The miracle to me is that anyone wants to work in science at all in the present state of universities. It is a sign, I guess, of just how wonderful it is to find something new, that people still put up with a system that seems, at times, not much different from slavery. See, for example, The Mismeasurement of Science by Peter A. Lawrence

.

(8) Not all the slavery is, of course, quite was bad as the famous chemist at Caltech who berated his slaves for not working (for his glory) seven days a week (though things not far short of this are quite common). And not all universities are quite so stupid as the Texas A&M University, which is reported to be thinking of hiring on the basis of the amount of grant income you bring in, although Imperial College London got alarmingly close to this sort of insanity. I guess I shouldn’t feel bad about other universities behaving in a way that makes anyone who is any good not want to work for them, but the matter is too important for one to worry about inter-university rivalry.

(9) The over-competitiveness and encouragement of trivial science, quantity rather than quality, has been going on for long enough now, that people who have risen on that basis now have power, and are to be found even on review panels of grant-giving bodies.

(10) Organisations like the Medical Research Council used to have permanent staff who developed a high level of expertise in the subjects they dealt with, and a great deal of expertise in the critical duties of knowing which referees to select, and how to judge what they wrote. More recently, the turnover of MRC staff has been too great for that sort of expertise to be well-developed, I have no axe to grind myself. My last program grant as PI (1999 – 2004) was funded, as was its successor (2004 – 2009, in which I was co-applicant). But recently I have seen feedback on failed grant applications (not mine) that suggest that the review panel either hadn’t read or hadn’t understood them.

(11) There is an enormous shortage of money for ‘response-mode’ grants. That means grants submitted by individuals to fund projects that the individual thinks will work. One reason for that is the research councils and charities have, increasingly, ring-fenced funds for work in a particular area, which some committee has decided ie important. Often this results in money being given to projects that don’t work very well (as I have seen at first hand when on the panel for the BBSCR Neuron initiative). These "initiatives" may sound good on paper to politicians, but they result in mis-spending of taxpayers’ money.

(12) One thing that Cable is dead right about ir that the ‘graduate tax’ is by far the fairest way to fund degrees. Sadly vice-chancellors line up to condemn it (you can’t get the staff these days).

### So what can be done?

I’ve listed a lot of criticisms, but what can be done about it?

I can see a couple of things that could be done. The main thing is to reduce the intense competitiveness that leads to low quality. The competitiveness arises in part because of the large increase in the number of universities that took place in 1992, when the then Conservative government converted at a stroke polytechnics and technical colleges into universities, This was done largely to increase the number of undergraduate students, something of which I advocate strongly. I also feel strongly that teaching at an advanced level should be done by people who are doing research in the area they are teaching about. This is what governments have tried to do since 1992, but the numbers just don’t add up. There are simply not enough good researchers to teach half the population, yet the promotion of everyone has been made to depend largely on research.

One way would be to retain honours degrees but make the post-1992 universities into teaching only institutions. That would be the wrong solution in my view. It would result in a lot of teaching being done by people barely able to cope with advanced stuff.

My proposal.

(1) The conservatism of some senior academics has meant that they have failed to recognise that the traditional honours degree is quite unsuitable for a mass education system in which 50% of people do a degree.

(2) We should abandon altogether the honours degree system, which attempts in 3 years to take people from high school level to research level in 3 years (even with smaller numbers of people it often failed to do that anyway).

(3) We should start with much wider general degrees where teaching could be at a lower level and be done in universities that did little research. Such degrees would still aim at critical thinking rather than being purely vocational. Reluctant though I am to see teaching and research separated, it has become an economic necessity and the harm should not be too great if the separation applies only to general first degrees,

(4) After this general first degree, students would either do vocational training, or if they wished to continue along the academic line, they would go to graduate school.

(5) By graduate school, I mean teaching in the advanced aspects of their chosen subject, as is done in the USA. Most UK universities now have something called a graduate school, but they are largely charades which teach advanced powerpoint presentation but nothing intellectual. Our own summer school was originally taught as part of the UCL graduate school, but was dropped by them on the grounds that it was education not training. Protests that a knowledge of mathematics was the ultimate transferable skill in science, fell on deaf ears.

(6) The graduate schools would be the place where the advanced teaching was done, and also where most research was done. To make this feasible for the staff, they would have little, or even no, undergraduate teaching. They’d be more like ‘institutes of advanced studies’.

(7) This proposed system is, of course, much more like the system in the USA than the present UK system. It’s worked rather well there. We should try it.

Once again some members of the Israeli defence force have shown behaviour worthy of an Auschwitz guard. Once again the old conflicts in my own mind are stirred up.  It is a bit like the second great march against the Iraq war.  Time has proved how right the marchers were, but we found ourselves walking alongside Islamic fundamentalists with whom we felt very little in common.  All it proves is the undesirable behaviour that results from religion – any religion.  Whether it is islam, judaism or christianity, the outcome is mayhem and murder.  There is no human so irrational and dangerous as those who believe they have god on their side.

It also shows, in my view, tha major mistake that was made after the second world war when the west tried to purge its collective remorse for the holocaust, but chose to do so at the expense of Palestinians. It was downright stupid to think that it was possible to put the clock back so far.

 Two good sources for today’s news.  Gaza flotilla activists were shot in head at close range And the eyewitness account by Swedish crime writer Henning Mankel who was on one of the original flotilla boats: ‘I think they went out to murder’ You can follow the progress of MV Rachel Corrie as she approaches Gaza at the WitnessGaza site

The name of Rachel Corrie is imprinted on my mind. It was the news that this 23-year old American college student had been callously crushed to death by an Israeli army bulldozer (made in the USA). That was the incentive to start my politics blog. I stopped maintaining that when Blair left office, but may occasionally get political here.

In her memory, here is a reproduction of my first political post, from 2003.

### A Great American.

 On Sunday, 16th March 2003, a 23-year-old American peace activist, Rachel Corrie, was crushed to death by a bulldozer as she tried to prevent the Israeli army destroying homes in the Gaza Strip You can read here some of the emails that she sent home before she died. And a reaction from Naomi Klein in the Globe and Mail (Toronto). ” Katharine Viner has edited her writings for a new play, on an ordinary woman with an extraordinary passion”. [Guardian]

John Sutherland documents some of the terrifyingly violent reactions of ‘patriotic’ Americans. [Guardian]

One ‘patriot’ wrote

“Anyone who would burn an American flag deserves to be bulldozed to death!!! Hopefully the US government will aim some bulldozers at the next group of war protesters, those anti-American motherfuckers.”

### And now another: Tom Hurndall

A British peace activist shot in the head while observing the Israeli army in Gaza, in April 2003, has died in hospital.

Tom Hurndall, 22, was overcome by pneumonia at the Royal Hospital for Neurodisability, in south-west London.

The Thomas Hurndall Fund has the latest news.

Watch videos of the murder and of an interview with his mother.

### A conviction at last!

Latest: after an indefatigable campaign by his parents to discover the truth, on 27 June 2005, a former Israeli soldier has been found guilty of the manslaughter of Tom Hurndall.

Ex-sergeant Taysir Hayb was convicted at a military court in Ashkelon for the shooting of Mr Hurndall in April 2003. Hayb will be sentenced at a later date.

In addition to the manslaughter verdict, Hayb was found guilty of obstruction of justice, incitement to false testimony, false testimony and improper conduct.

[Hurndall’s father said] “We’re concerned that there is a policy which seems to be prevalent in Gaza, amongst the Israeli soldiers and army, that they feel able to shoot civilians really without any accountability whatsoever.”

Civil liberties group Human Rights Watch last week accused Israel of investigating less than 5% of hundreds of cases of Palestinians killed since 2000.

On 11 August 2005 the BBC reported that Hayb was convicted to 8 years in jail, 7 years for manslaughter and 1 year for the other charges. Amnesty International’s Kate Allen said that while the person responsible for Mr Hurndall’s death had been brought to justice, it was

“striking that this was almost entirely due to tireless campaigning by his family”.

“The strong suspicion is that if Mr Hurndall’s family had not shown utter determination to uncover the truth of their son’s death, then no-one would ever have faced justice for what happened to Tom,”

One member of parliament, above all others, has championed reason for the last 13 years, But Evan Harris was not re-elected in Oxford West and Abingdon. On May 6th he got 23,730 votes, a mere 176 votes fewer than his conservative rival.

Click picture to see hero movie (be patient) (or right click to download mpg file)

Let me declare an interest. Evan Harris is one of the most principled men I have ever had the pleasure to meet. His stands on human rights, civil rights and libel law reform have been exemplary. He is also one of the few (and now fewer) members of parliament who understands how science works and its importance for the future of the UK. He has been a tireless advocate for the idea that policy should be based on evidence (as opposed to guesswork)..

Harris is also an atheist, something that one would not expect to be very relevant in a country where the influence of religion has declined progressively for many years. It would not be relevant if it were not for the fact that his defeat was brought about by poisonous lies propagated by, ahem, evangelical christians. I’m an atheist too, but I have met some good christians, I think they are wrong about their sky fairies, but I also think they should be free to believe in them if they want. Some of them do good things as a result of their beliefs. But not in Oxford West and Abingdon.

The (just) winner was conservative Nicola Blackwood. She is a member of the Conservative Christian Fellowship. But curiously a search of her web site for ‘christian’ shows not a single result. Shouldn’t voters know about your beliefs? It seems distinctly dishonest not to admit that your views come from an old book as interpreted by old men, The voter should know your motives.
Her profile at the Conservative Christian Fellowship says

“Along with many Christians, she is concerned that right to freedom of religion is being undermined without proper understanding of the potential consequences for faith groups or the wider community. In particular, she fears that the voice of Christians and people of other faiths on key issues of conscience is too readily dismissed in public debate.”

### But what did Nicola Blackwood know about the smear leaflets?

Nicola Blackwood’s web site not only doesn’t mention the word ‘christian. It says very little about policies of any sort, There is no
mention of euthanasia or any of the other questions raised in pamphlets that were distributed throughout the constituency. There is a well hidden disclaimer

"Nicola has distanced the Conservative Party from literature distributed by private individuals and special interest and pressure groups attacking her opponent".

That is a pretty weak response to the poisonous and inaccurate leaflets that were circulated (they can be seen here). The worst stuff came form two sources

The Reverend Lynda Rose.

Lynda Rose is an Anglican minister who seems to think it appropriate to call a good man "Dr Death" because of her religious ‘principles’. Here is part of her leaflet

Lynda Rose has extreme "pro-life" views, more like those of the pope than of the average anglican. She seems not unlike the extreme right wing fundamentalist religious groups found in the USA. Harris told the Oxford Mail that

“It is a pity that, instead of putting up a candidate to contest the election, an anonymous group, using money from no-one knows where, is distributing an inaccurate personal attack leaflet in this constituency for the first time ever.

“It is offensive and I would say profoundly unchristian to use the term Dr Death – associated with Nazi murderer Joseph Mengele or mass-murderer Harold Shipman – to describe any politician.”

The Reverend Rose replied to the this in a letter to the Oxford Mail (April 26th) that is reproduced on the web site Anglican
Mainstream
("Anglo-catholic, Evangelical, Orthodox, Charismatic, Mainstream"). There is not a word of apology for vilely defamatory use of “Dr Death”, but merely a huffy defence of Hansard’s voting records.

That takes some beating as uncharitable, intolerant, inaccurate (and defamatory) comment. But there is even worse to come.

Keith Mann was another candidate in the same election. In 1994 Mann was sentenced to 14 years in jail, reduced to 11 years on appeal, for 21 offences including possession of explosives, incitement, criminal damage, and escape from custody (from Wikipedia). His leaflets were even worse than those of the Reverend Lynda Rose.

This vile calumny, full of inaccurate allegations and written by someone wth a serious criminal record, was aimed at a deeply-principled man. No doubt helped Nicola Blackwood to scrape in, but I can find no direct denunciation of it from Ms Blackwood. Christians don’t seem to be fussy about their allies.

Then there were the newspapers, in particular the Daily Telegraph.

Cristina Odone was editor of the Catholic Herald from 1991 to 1996.  She is another ‘good christian’ who wrote an abominably nasty piece in the Daily Telegraph on April 19th. The Lib Dems are a Jekyll and Hyde party. Forget nice Mr Clegg. What about ‘Dr Death’? It is worth looking at it as a prime example of inaccurate, ad hominem, nastiness. It is also worth looking at for the comments: there were a lot of comments (thanks to an alert via Twitter) and most of them were along the lines of this of one of the first, from the redoubtable skepchick

"Thanks for the heads up, Cristina! Now I know to cheer for the LibDems. I want to know that if I end up in a vegetative state, I’m given a peaceful death rather than my own Telegraph column."

Most importantly, read the calm, diginified and polite response from Evan Harris himself.

I have never said that that the current abortion rate is not of import (you just made that up Christina!) and indeed have argued for more effective sex and relationships education as other countries manage and which also delays first sexual intercourse. And for better access to effective contraception. We can disagree on that too but best to have a rational discussion rather than a distortion.

I have never said “God is bad, his followers mad”. You made that up again Christina! I respect the religious view actually but believe that the state should be neutral on religion and it should not be privileged by the state above other beliefs.

My own comment took a while because of the Telegraph’s clunky registration system.

“This truly vile piece of writing shows all the tolerance of an Ayatollah who advocates rule by religious dogma (well actually, of course, by his own opinions). There could hardly be a worse moment to seek to impose catholic values on the rest of society. That church, including its head, has been seem to fail to report to the police the most vile crimes. It is in deep disgrace precisely because of its lack of moral principles.

One thing was very clear: she doesn’t understand the web. Her follow-up article seemed to think that the response was organised by Lib Den HQ! The Lib Dems’ spooky posse of internet pests. Sorry, Ms Odone, but these days concerned individuals can speak up.

The Reverand Goerge Pitcher, anglican minister at St Bride’s church, Fleet Street, was the next priest to bring disgrace on christianity with another incredibly nasty piece, again in the Telegraph, The best result of the election: Let’s rejoice that Lib Dem Evan Harris has lost his seat.

Again there were many hostile comments, including quite a lot from christians.

“Speaking as a Christian, I find it amazing how many Christians are capable of being thoroughly nasty about people they dislike. I have made a mental note that if I ever find myself seeking a church in central London, I shall avoid St Brides, Fleet St like the plague.”

and from ex-christians

“Dr Evan Harris is more of a doctor than either you or Nadine Dorris are “human beings”. You are both spiteful, evil people, and you are exactly the sort of person that drove me to reject the Catholic Church, and ask for an official notice of my defection to be placed in the baptismal register of my parish.”

Father Raymond Blake is another cleric who thinks you should vote according to his interpretation of the bible. His web site is as political as that of the christian taleban of the southern USA,
and just about as charitable.  He too uses the "Dr Death" abuse, with no consideration of what Harris actually advocates.

### How is it that christians (and homeopaths) can be quite so unpleasant?

Religious people, and those with other belief systems that resemble religions are supposed, traditionally, to be warm, caring people, charitable, forgiving and selfless, That, at least is the image they like to cultivate. Of course it has never been quite as simple as that. Just think of the inquisition, the warring catholics and protestants and, right now, the sordid disgrace of child rape, and its cover up by the highest officials of the vatican.

Last easter, I added a bit to the 2008 diary section of this blog about why I’m not a christian It seems to be worth repeating here.

"When I was about 15 I went to a Summer camp which turned out to be run by christian evangelists (my parents swore they didn’t realise that it was a brain-washing camp).  I was converted and became rather earnest.  Then, at 18, I met a nurse.   Being on Merseyside, she was Irish. And being 18, I was rather interested in sex.  The price of sex was to go with her to mass, so of course I went.  It was Easter and they were doing the Twelve Stations of the Cross.  I still recall watching this, with mounting horror.  The priests were just enjoying it too much.  It was almost like a sado-masochistic orgy.  The priests seemed to be almost masturbating.   It was simply sick."

I was reminded of this streak of cruelty that runs through christianity by the comment made by an aide to Tony Blair who said

“I couldn’t help feeling TB was rather relishing his first blooding as PM, sending the boys into action. Despite all the necessary stuff about taking action ‘with a heavy heart’, I think he feels it is part of his coming of age as a leader.”

His enthusiasm for a war that has killed over 100,000 people (and cost a small fortune) seems sadly consistent with his catholicism,

Despite all this, some individual religious people have done good for humankind.

Likewise proponents of magic medicine are proud of their individual caring approach and this may indeed be helpful in eliciting a good placebo response.

The problem seems to be that neither group can tolerate criticism. They aren’t interesting in discussing anything, because they just know they are right. And if anyone tries to express an opinion that differs from their own, the niceness vanishes like the snow in spring.

The quotations above show the downright nasty vindictiveness of religious people towards an honourable man who happens to hold somewhat different views to their own.

Likewise the cuddly homeopaths show astonishing abusive nastiness to anyone who doesn’t believe in their magic. I allow them to say what they want on this blog but they routinely delete comments. Along with most of my scientific friends, I’ve been subject to abuse and utterly incorrect allegations. I don’t enjoy it, but if its the price of free speech, so be it.

I fear that these things represent the incursion into UK politics of the extreme polarisation seen in the USA. a place where religious people seem to think it is moral to shoot doctors who do abortions.

Some morality. Thank you Tony Blair.

### Some other blogs on this topic

A liberal Dose (Neil Fawcett) wrote Extremists to the left of me, fundies to the right.

Richard Dawkins wrote Evan Harris: Is this why he lost his seat?

Ophelia Benson wrote three good posts (via comment from Swiss Frank)

http://www.butterfliesandwheels.org/2010/gloating-for-britain/

http://www.butterfliesandwheels.org/2010/byrnes-on-harris-pitcher-on-pitcher/

http://www.butterfliesandwheels.org/2010/peculiar-george/and, via Butterflies and Wheels,

Clifford Longley has trenchant comment on Platitude of the Day

### Follow-up

Texas schools board rewrites US history with lessons promoting God and guns.     Chris McGreal, in the Guardian writes about the sort of thing that the clerics mentioned here might love.

“US Christian conservatives drop references to slave trade and sideline Thomas Jefferson who backed church-state separation”

“Several changes include sidelining Thomas Jefferson, who favoured separation of church and state, while introducing a new focus on the “significant contributions” of pro-slavery Confederate leaders during the civil war.”

“The new curriculum asserts that “the right to keep and bear arms” is an important element of a democratic society. Study of Sir Isaac Newton is dropped in favour of examining scientific advances through military technology.

There is also a suggestion that the anti-communist witch-hunt by Senator Joseph McCarthy in the 1950s may have been justified.

The education board has dropped references to the slave trade in favour of calling it the more innocuous “Atlantic triangular trade”, and recasts the Israeli-Palestinian conflict as driven by Islamic fundamentalism.”

I voted labour in every election (apart from my very first) up to and including 1997.  This is about my feelings for the 2010 election.  Make up your own mind (but don’t let Rupert Murdoch manipulate you).

Don’t Get Fooled Again “I agree with Rupert

By 2001 election, I had been forced to the conclusion that Tony Blair had views that were well to the right of Margaret Thatcher’s, in many areas that mattered to me. so I voted Lib Dem. That was before 9/11 After that event, all doubt was gone, so the 2005 election it was Lib Dem again.

I won’t even consider the Conservative party much.  I have never understood how anyone could vote for them, ever. The only choice for me is Lib Dem versus Labour.  Let’s try to be fair.  Labour has done some good things (though most of them would probably have been done by Lib Dems too).

• Minimum Wage Act 1998 was a great innovation
• The Freedom of Information Act (2000) was a major step forward for openness and democracy.
• Nursery school places have increased
• Heating allowances for pensioners (though not sure that I should have got it)
• The funding for the NHS was increased considerably and it has been very good for me (see Why I love the NHS).
• Funding for science increased considerably

Against the big increases for the NHS must be set the huge increase in the number of highly-paid managers, relative to the number of nurses and doctors, that has occurred under Labour.

### Bad things that labour has done

It was obvious from an early stage that Labour were in favour of selective schools (but were not honest about).  They certainly favoured religious selective schools, and still do.

The explicit support of Tony Blair for creationist schools and his implicit support for homeopathy are distasteful, but not in themselves sufficient reason for voting against him. The decisive thing for me is the Labour government’s careless attitude to human rights and free speech.

Nothing made that clearer than the Iraq war and its aftermath.

Saddam Hussein was a wicked dictator, Sadly the world has many wicked dictators. One wishes they would all go away. But only one of the world’s wicked dictators was singled out to be invaded. It was already clear before 1997that Iraq had been picked out by American neoconservatives as a ‘special case’. They didn’t get far until the election of George Bush in 2001, and the tragedy of the twin towers, 9/11, gave them the chance they sought.

George Bush was perhaps the most extreme right wing president in US History (as well as one of the most stupid). As someone who seemed to have difficulty in distinguishing between real life and a B-movie, his behaviour may not be surprising, but it brought shame on his country. His regime’s legitimisation of torture is, to my mind, the greatest disgrace that has happened during my adult lifetime.

It was with increasing incredulity that I watched Tony Blair’s poodle-like behaviour to Bush. It seemed incredible that any normal human. let alone a Labour prime minister could behave like that. The sight of two such men, both believing that god was on their side was scary in the extreme.

Some things are in danger of being forgotten with the passing of time.  All these and much more were documented on my politics blog, up to the point when Blair left office.

• Remember the US governments legalisation of torture. That caused no wavering in Blair’s support.
• Remember the plagiarised dossier? Any student would have been fired for that, but Blair shrugged it off.
• Remember how the attorney general mysteriously changed his mind about the legality of the war?
• Remember Abu Ghraib?  If not, read Seymour Hersh.
• Remember the ex-aide to Blair who said

“I couldn’t help feeling TB was rather relishing his first blooding as PM, sending the boys into action. Despite all the necessary stuff about taking action ‘with a heavy heart’, I think he feels
it is part of his coming of age as a leader.”

and how the government tried to tone down his remarks.

• Remember David Kelly? The death of a good man must be largely the fault of Blair’s government.
• Remember how, eventually, generals and even neocons turned on Bush, but Blair would still not admit any mistake?
• Remember the Hutton report, and the vicious attacks on the BBC’s independence that followed it?
• Remember the attempts to conceal ‘rendition’ (i.e. .torture by proxy).
• Remember the wonderful efforts of UCL lawyer, Phillipe Sands, to expose illegal activities by both US and UK governments. He is someone of whom UCL can be very proud.

The good done by the Freedom of Information Act has to be set against their sloppy attitude to human rights, as evidenced by their constant attempts to extended detention without charge or trial. In 2004 I made the following poster, based on a dramatic front page of the Independent, 18th Dec. 2004. It is still relevant.

Click to enlarge

This followed the ruling pf the Law Lords that the government’s detention policy was illegal

“The real threat to the life of the nation, in the sense of a people living in accordance with its traditional laws and political values, comes not from terrorism but from laws such as these. That is the true measure of what terrorism may achieve. It is for Parliament to decide whether to give the terrorists such a victory.” Lord Justice Hoffmann, in the 8-1 ruling of the Law Lords that the UK government’s policy of detention without charge is illegal. [Washington Post] , [Original report]

The sight of Blair acquiescing to the wish of the most right-wing neoconservative government in the western world sickened me unspeakably, and still does, The happy days of 1997 seemed to be a long way away.

That was Blair, but Gordon Brown and most of the Labour cabinet looked on and did nothing.

David Miliband said “You’ve punished us enough about Iraq”. Well no, you haven’t been punished at all, Yet. As someone said on twitter, resuscitate the 100,000 dead and we’ll forgive you.

 I’m still baffled about why the crowd that gathered in UCL’s quad for the start of the second great march on 20th March 2003, were able to predict the outcome of the invasion so much more accurately than the government. UCL  quadrangle 20 March 2003 Click here to download high resolution

### Apart from the war

Brown is guilty not only of supporting the war.

He has supported segregated religious schools and the reintroduction of "academy" schools, both being ways of surreptitiously re-introducing selection into the education system

He and Blair presided over an endless multiplication of box-ticking quangos. The intention was, no doubt to increase quality, but the effect has been exactly the opposite. Just look, for example, at Skills for Health, the QAA, the QCA and a multitude of others.

These are some of the reasons that I cannot vote "Labour" this time. They have become. in many ways, a party of the right, barely distinguishable from the Conservative party (and in some respects, further to the right). Remember that the Conservatives supported Blair in his love affair with George Bush, they support selective schools, they support religious schools. And they are even more likely that Labour to sell their soul to Rupert Murdoch. Imagine Fox "News" coming to the UK and be afraid, very afraid.

### Why Liberal Democrats?

Since I find it impossible to vote Labour this time. they are the only option. But I think one can be a bit more positive than that.

Some of the reasons why are listed in a letter in today’s Guardian (the list of signatories is remarkable). The Lib Dem manifesto is here.

• The Lib Dems are more likely than the other parties to roll back New Labour’s attack on civil liberties
• Lib Dems tax and green policies look pretty good to me.
• The cost of replacing Trident missiles could be around £100 billion, and if that were spent it is doubtful whether what you get is useful under present conditions. Only Lib Dems would rethink this ghastly waste of money. Brown and Cameron prefer macho posturing.
• Brown’s judgment about banks was wrong, yet he still won’t separate the casino banks and the savings banks. Lib Dem’s would.
• Lib Dems have been more open about how cuts would be made than other parties (if not 100%). Vince Cable for Chancellor.
• Nick Clegg’s response to the letter sent party leaders by the Campaign for Science & Engineering CaSE) was clearly better than the others,in many respects. See also Lib Dems science policy test
• Can you imagine a better science minister than Dr Evan Harris?. I can’t.

### Follow-up

Yet another university has stopped its homeopathy course. The particular interest of this course was that it was being run at Robert Gordon University, Aberdeen, the vice-chancellor which was Michael Pittilo, until his recent premature death. Pittilo is the person who recommended to the government that herbalists and Chinese medicine practitioners should get honours degrees and be regulated like doctors. His report, was, in my opinions, disastrously bad

It recently emerged that this, very bad, advice would not be accepted by the Department of Health (DH), so the campaign against the Pittilo proposals, on this blog and elsewhere was successful. The alternative DH proposals look pretty silly, but we won’t really know until after the election exactly what will happen.

Robert Gordon University (RGU): is the ‘post-1992’ university in Aberdeen, as opposed the the University of Aberdeen (where my son is at the moment). Much of RGU does an excellent job, but like so many post-1992 universities they harm themselves by running courses in barmy alternative medicine. RGU ran an Introduction To Homeopathy module (saved 9 April 2010).

In July 2009, I asked RGU to see some samples of the teaching materials on this module, partly as part of the campaign against Pittilo’s proposals. I asked to see the powerpoints and handouts for three lectures, (1) evidence for homeopathy, (2) first aid remedies, and (3) allergies.

In September 2009, this request, made under the Freedom of Information Act (Scotland), was, as always, rejected by RGU, though they did tell me that the evidence lecture had been produced by a lecturer from The Faculty of Homeopathy and the other two had been produced by a local GP.

So, as usual, I asked for the mandatory internal review of the decision. In October, the review upheld the original decision, as they almost always do. I referred the decision to the Scottish Information Commissioner (the law is slightly different in Scotland) and they have still not responded.

But on 8 April 2010 I got a letter from RGU.

 “The above course requested is no longer part of the School of Nursing and Midwifery’s provision, and it was cessated [sic] in Semester One 2009/10. This followed a formal review of all Nursing and Midwifery modules and their viability. In the light of this the university has decided to release the information.”

So yet another university has done the sensible thing. The course has been shut. Just for the record, I’ll reproduce a few of the slides from the lecture on “homeopathic remedies for allergies”.

Allergies can be dangerous, and occasionally lethal. To treat them with homeopathic pills, medicines that contain no medicine, is not just delusion, but a dangerous delusion which risks the lives of patients.

The "remedies" include nettles, sulphur, petroleum and arsenic.  They’d be pretty scary but in fact the pills contain, in most cases, not a jot of nettle, sulphur, petroleum or arsenic.  Homeopathic pharmacies stock thousands of bottles of identical sugar pills, each with a different label.

These dangerous delusions were being taught as fact in a UK university.  The shame of it..

Update 12 March. Six more dimwits signed.

An‘early day motion1 (EDM 908) has been tabled in parliament which opposes the conclusions of the science and technology committee report on the evidence for homeopathy. After two weeks it has been signed by an amazing 55 MPs. That is 8.5% of all 646 MPs.  Nothing shows more clearly the scientific illiteracy that prevails in the House of Commons (and, perhaps, the results of the mass mailing of MPs by homeopaths, who are clutching at straws)..

These MPs are all people who have difficulty with the idea that pills which contain nothing can have no effect above placebo.  It isn’t rocket science.

Those of us who spend quite a lot of unpaid time trying to communicate the joy of science to the public, rather resent having our efforts undermined by these members of parliament.  But at least we now have a handy list of them.

In case this seems a bit harsh, it is only necessary to point out that the EDM was tabled by David Treddinick (Cons, Bosworth). Mr Treddinick is renowned as the most extreme advocate of magic medicine
in the House of Commons.  The EDM twists and distorts the evidence in exactly the way the committee’s report condemned so sternly.

Nothing is too barmy for Treddinick to espouse. His education at Eton and Oxford has led him to advocate homeopathic borax for the treatment of foot and mouth disease, and he has backed homeopathic treatment of AIDS and malaria. He is a major danger to public health. By way of background, Tredinnick was suspended for a month without pay for taking a £1000 bribe in the cash for questions scandal. And he was again in trouble during the expenses scandal. It was reported that

“The MP for Bosworth struck a deal with the parliamentary standards commissioner to pay back the £755 which he claimed for a computer programme that states it can help users to predict their health via the stars.”

Yes, really, astrology! You couldn’t make it up.

One would think that, with a reputation like this, nobody with half a brain would want to sign an EDM proposed by Treddinick. Well, not so. The list of signatories is amazing, and shocking.

The state of the parties is interesting.

Unionists (Northern Ireland): no fewer than 77% (7 out of 9 MPs) signed, including the infamous Ian Paisley and the recently famous Peter Robinson. Disheartening though this is, perhaps it isn’t so surprising from a group noted for religious belief, and consequently predisposed to believing things that aren’t true.

The seriously sad thing is that second place in the stupid race is held by – wait for it – the Liberal Democrats, with 15.9% (10 of their 63 MPs). That is tragic in the light of the fact that two of the very few MPs in the House with any appreciation of evidence are also Lib Dems, Phil Willis and Evan Harris (both on the Science and Technology Committee).

After them Conservatives with 8.3% (16 out of 193), and the best is Labour 5.8% (20 out of 346 MPs)

Here is the roll of shame, updated on 12 March (the last six signed in the last 24 hours)

 Tredinnick, David Con Simpson, Alan Lab Russell, Bob LibDem Pound, Stephen Lab Dismore, Andrew Lab Simpson, David Democratic unionist McDonnell, John Lab Campbell, Gregory Democratic unionist Cohen, Harry Lab Corbyn, Jeremy Lab Drew, David Lab Gray, James Con Hancock, Mike LibDem Hermon, Lady Ulster unionist Key, Robert Con Hemming, John LibDem Bone, Peter Con Davies, Dai Independent Mates, Michael Con Dodds, Nigel Democratic unionist Wyatt, Derek Lab Sarwar, Mohammad Lab Hamilton, Fabian Lab Winterton, Nicholas Con Davies, Philip Con Leigh, Edward Con Barlow, Celia Lab Ellwood, Tobias Con Leech, John Lib Dem Main, Anne Lab Robinson, Peter Democratic unionist McCrea, Dr William Democratic unionist Paisley, Ian Democratic unionist Brady, Graham Con Cook, Frank Lab Hall, Patrick Lab Binley, Brian Con Pugh, John Lib dem Davey, Edward Lib dem Weir, Mike Scottish Nationalist Sharma, Virendra Kumar Lab Abbott, Diane Lab Williams, Mark Lib dem Horam, John Con Widdecombe, Ann Con Browne, Jeremy Lib dem Spicer, Michael Con Maclean, David Con McCafferty, Chris Lab Buck, Karen Lab George, Andrew Lib Dem Vis, Rudi Lab Walter, Robert Lab Whittingdale, John Con Farron, Timothy Lib Dem

I haven’t contacted most of these MPs, and of those I have only two have replied.  I had a rather curt reply from one of the most surprising signatories (John Hemming, who was a Scholar in Theoretical, Atomic and Nuclear Physics at Magdalen College, Oxford.

### Mark Twain’s letter

a letter written in 1905 by Mark Twain.  It refers to an Elixir of Life.  By curious coincidence this popped up a week after I saw Donizetti’s L’Elisir d’Amore at ENO (and a couple of days after I bumped into its producer, Jonathan Miller, in the RADA café). I’d love to quote Kelly Rourke’s witty translation of the quack’s song, but can’t find the libretto.

Given the ludicrous libel laws in the UK. I’d like to make it clear that the following item has absolutely nothing to do with EDM 908.  Please sign the petition at http://libelreform.org/

You’re an idiot of the 33rd degree

In November of 1905, an enraged Mark Twain sent this superb letter to J. H. Todd, a patent medicine salesman who had just attempted to sell bogus medicine to the author by way of a letter and leaflet delivered to his home.

 Nov. 20. 1905 J. H. Todd  1212 Webster St. San Francisco, Cal. Dear Sir, Your letter is an insoluble puzzle to me. The handwriting is good and exhibits considerable character, and there are even traces of intelligence in what you say, yet the letter and the accompanying advertisements profess to be the work of the same hand. The person who wrote the advertisements is without doubt the most ignorant person now alive on the planet; also without doubt he is an idiot, an idiot of the 33rd degree, and scion of an ancestral procession of idiots stretching back to the Missing Link. It puzzles me to make out how the same hand could have constructed your letter and your advertisements. Puzzles fret me, puzzles annoy me, puzzles exasperate me; and always, for a moment, they arouse in me an unkind state of mind toward the person who has puzzled me. A few moments from now my resentment will have faded and passed and I shall probably even be praying for you; but while there is yet time I hasten to wish that you may take a dose of your own poison by mistake, and enter swiftly into the damnation which you and all other patent medicine assassins have so remorselessly earned and do so richly deserve. Adieu, adieu, adieu! Mark Twain

1 For those who are not familiar with the quaint customs of the UK parliament, early day motions can be tabled by any MP but are rarely debated and even more rarely lead to any action.

### Follow-up

The Guardian had picked up on this story on the same day that it was posted, in a nice article by Ian Sample .

Des Spence, a general practitioner in Glasgow, has revealed a memorandum that was allegedly leaked from the Department of Health. It was published in the Britsh Medical Journal (17 June 2009, doi:10.1136/bmj.b2466, BMJ 2009;338:b2466). It seemed to me to deserve wider publicity, so with the author’s permission, I reproduce it here. It may also provide a suitable introduction to a forthcoming analysis of a staff survey.

 Re: The use of ‘note pads’ in the NHS and allied service based agencies. Hi, all care providers, managers of care, care managers, professions allied to care providers, carers’ carers, and stakeholders whose care is in our care. (And a big shout to all those service users who know me.) We report the findings from a quality based review, with a strong strategic overview, on the use of “note pads” across all service user interfaces. This involved extensive consultation with focus groups and key stakeholders at blue sky thinking events (previously erroneously known as brain storming). This quality assured activity has precipitated some heavy idea showers, allowing opinion leaders to generate a national framework of joined-up thinking. This will take this important quality agenda forward. A 1000 page report is available to cascade to all relevant stakeholders. The concentric themes underpinning this review are of confidentiality. Notes have been found on the visual interface devices on computers and writing workstations throughout the NHS work space. Although no actual breach of confidentiality has been reported, the independent external consultants reported that note pads “present a clear and present danger” to the NHS, and therefore there is an overarching responsibility to protect service users from scribbled messages in felt tip pen. Accordingly all types of note pads will be phased out in the near time continuum. A validated algorithm is also attached to aid this process going forward. This modernising framework must deliver a paradigm shift in the use of note pads. Care provider leaders must employ all their influencing and leverage talents to win the hearts and minds of the early adopter. A holistic cradle to grave approach is needed, with ownership being key, and with a 360 degree rethink of the old think. All remaining note pads must be handed over in the next four week ” note pad armistice” to be shredded by a facilitator (who is currently undergoing specialist training) and who will sign off and complete the audit trail. (Please note that the NHS’s email system blocks all attachments, so glossy, sustainable, wood based hard copies will be sent directly to everyone’s waste recycling receptacles.) Cite this as: BMJ 2009;338:b2466

Spence added a footnote, Note: The BMJ’s lawyers have insisted that I make it clear that this is a spoof, just in case you were wondering.

### Here are a few more

 There is an initiative underway to determine what we do as an organisation in the realms of drug discovery. The intention is to identify internal and appropriate external capabilities to foster a pipeline of competencies that enable some of our basic research outputs to better impact healthcare.

### Follow-up

This is another short interruption in the epic self-destruction of chiropractors.  In a sense it is more serious.  One expects quacks to advocate quackery.  What you don’t expect is that the National Institute of Clinical Excellence (NICE) will endorse it.  Neither do you expect the Medicines and Healthcare products Regulatory Agency (MHRA) to betray its mandate to make sure that medicines work.

The saga of the NICE low back pain guidance has been the subject of a deluge of criticism, It seems doubtful that the guidance can survive, not least because of its absurd endorsement of chiropractic, at a time when chiropractic is undergoing self-immolation as a consequence of the persecution of Simon Singh by the British Chiropractic Association (see here, and here, and here, and here and thousands of other sites).

The other betrayal has come to the for after the MHRA approved highly misleading labelling of a homeopathic preparation.  At the time,
in 2006
, when the principle was approved by the MHRA, just about every scientific organisation, even the Royal Society, condemned the action.  What was discouraging that the clinical organisations all stayed silent.  It is still a mystery why the MHRA made this enormous mistake,  Some said that European regulations required it, but that is quite untrue, as Les Rose has shown.  It appears to have been the result of a pusillanimous MHRA bowing to pressure from a deeply unscientific Department of Health (a letter from Caroline Flint at the time borders on the surreal).

On 20 May 2009, the British Medical Journal printed an article Drugs agency grants its first licence to homoeopathic product by Deborah Cohen (available free). The comments were mostly highly critical of the MHRA. The BMJ asked, as it does from time to time, for my comment to be converted to a letter
for the print edition
. That isn’t freely available, so here it is.

Published 9 June 2009, doi:10.1136/bmj.b2333
Cite this as: BMJ 2009;338:b2333

## Homoeopathic product licence

### MHRA label seems to be illegal

The strap line for the Medicines and Healthcare products Regulatory Agency (MHRA) is “We enhance and safeguard the health of the public by ensuring that medicines and medical devices work and are acceptably safe.”

Yet the MHRA has made mockery of its own aims by ignoring the bit about “ensuring that medicines work” and allowing Arnica 30C pills to be labelled: “a homoeopathic medicinal product used within the homoeopathic tradition for the symptomatic relief of sprains, muscular aches, and bruising or swelling after contusions.”1

This label should be illegal anyway because the pills contain no trace of the ingredient on the label, but this deceit has been allowed through a legal loophole for a long time now. If you sold strawberry jam that contained not a trace of strawberry you’d be in trouble.

But I can see no legal loophole that allows the manufacturers of Arnica 30C to evade the provisions of the Consumer Protection from Unfair Trading Regulations 2008. One of the 31 commercial practices which are in all circumstances considered unfair is “falsely claiming that a product is able to cure illnesses, dysfunction, or malformations.”

The consumer protection laws apply to the way that “the average consumer” will interpret the label. The average consumer is unlikely to know that “used within the homoeopathic tradition” is a form of weasel words that actually means “there isn’t a jot of evidence that the medicine works.”

Since there is not the slightest evidence that Arnica 30C pills provide symptomatic relief of sprains, etc, the labelling that the MHRA has approved seems to be illegal. The MHRA is not selling anything itself, so I presume that it won’t find itself in court, but anyone who follows its advice could well do so.

Cite this as: BMJ 2009;338:b2333

David Colquhoun, research professor1

University College London, London WC1E 6BT

Competing interests: None declared.

#### References

1. Cohen D. Drugs agency grants its first licence to homoeopathic product. BMJ 2009;338:b2055. (20 May.)

It is, I suppose, just a sign of the chaos that reigns in the multiple agencies and quangos responsible for ‘regulation’  that one arm of government proposes action that a different branch would consider illegal.  That is an inevitable consequence of trying to regulate something without first deciding whether it is nonsense or not.  The Department of Health appears to be quite incapable of grasping this simple and obvious fact.

### Follow-up

Health: best treatments. The Guardian seems to the be picking up BMJ stories and ran this one.

 One of the most extraordinary bits of journalism I’ve read for a long time appeared as an editorial in the Sri Lankan newspaper, the Sunday Leader, on Sunday January 11th 2009   It was reproduced in the Guardian on 13th January, and in The Times.  It was written by Lasantha Wickrematunge, editor of the Sunday Leader, and it was the last thing he wrote. Days after writing it he was assassinated.

It is a plea for freedom of speech. In particular, for the freedom of journalists to tell the truth,  It is deeply moving and it is also written in more beautiful English than many native speakers can manage. The second person to leave a comment in the Guardian said

“Extraordinary, humbling and deeply moving.

Cif Eds, please leave this at the top of the page for about a week, and then nail copies it to every available surface at Guardian HQ.”

Writing blogs like this one (and a thousand others) need some of the skills of investigative journalism.  Those skills are not so different from those you need in science, Curiosity, a willingness to look under stones, a preference for truth over myth, some skill with  Google and a good deal of tenacity.  You also need to be resilient to abuse and defamation by people who disagree with you.  But you do not risk your life. It does not take much courage.  That isn’t true in large parts of the world.

Read it all. Here are a few quotations to persuade you it’s worth the time.

“No other profession calls on its practitioners to lay down their lives for their art save the armed forces – and, in Sri
Lanka
, journalism. In the course of the last few years, the independent media have increasingly come under attack. Electronic and print institutions have been burned, bombed, sealed and coerced. Countless journalists have been harassed, threatened and killed. It has been my honour to belong to all those categories, and now  especially the last.”

“The Sunday Leader has been a controversial newspaper because we say it like we see it: whether it be a spade, a thief or a murderer, we call it by that name. We do not hide behind euphemism. The investigative articles we print
are supported by documentary evidence thanks to the public-spiritedness of citizens who at great risk to themselves pass on this material to us. We have exposed scandal after scandal, and never once in these 15 years has anyone proved us wrong or successfully prosecuted us.”

“The free media serve as a mirror in which the public can see itself sans mascara and styling gel. From us you learn the state of your nation, and especially its management by the people you elected to give your children a better future.”

“It is well known that I was on two occasions brutally assaulted, while on another my house was sprayed with machine-gun fire. Despite the government’s sanctimonious assurances, there was never a serious police inquiry into the perpetrators of these attacks, and the attackers were never apprehended.

In all these cases, I have reason to believe the attacks were inspired by the government. When finally I am killed, it will be the government that kills me.”

“In the wake of my death I know you will make all the usual sanctimonious noises and call upon the police to hold a swift and thorough inquiry.

But like all the inquiries you have ordered in the past, nothing will come of this one, too. For truth be told, we both know who will be behind my death, but dare not call his name. Not just my life but yours too depends on it.

As for me, I have the satisfaction of knowing that I walked tall and bowed to no man. And I have not travelled this journey alone. Fellow journalists in other branches of the media walked with me: most are now dead, imprisoned
without trial or exiled in far-off lands.”

“People often ask me why I take such risks and tell me it is a matter of time before I am bumped off. Of course I know that: it is inevitable. But if we do not speak out now, there will be no one left to speak for those who cannot,
whether they be ethnic minorities, the disadvantaged or the persecuted. An example that has inspired me throughout my career in journalism has been that of the German theologian, Martin Niemöller. In his youth he was an antisemite and an admirer of Hitler. As nazism took hold of Germany, however, he saw nazism for what it was. It was not just the Jews Hitler sought to extirpate, it was just about anyone with an alternate point of view. Niemöller spoke out, and for his trouble was incarcerated in the Sachsenhausen and Dachau concentration camps from 1937 to 1945, and very nearly executed. While incarcerated, he wrote a poem that, from the first time I read it in my teenage years, stuck hauntingly in my mind:

First they came for the Jews
and I did not speak out because I was not a Jew.

Then they came for the Communists
and I did not speak out because I was not a Communist.

Then they came for the trade unionists
and I did not speak out because I was not a trade unionist.

Then they came for me and there was no one left to speak out for me.

If you remember nothing else, let it be this: the Leader is there for you, be you Sinhalese, Tamil, Muslim, low-caste, homosexual, dissident or disabled.”

This man puts to shame the those who won’t speak out in the safety of the West, despite the fact that they have nothing to lose but their ministerial jobs or their knighthoods. Or running the risk of being sued by chiropractors.

How about some nominations for Western journalists who live up to these ideals?   I’d start with Seymour Hersh and Paul Krugman in the USA, and our own Ben Goldacre.   It’s interesting though, that two of these three are not full time journalists. Blogs do rather better than most newspapers. They have become an important force for freedom of speech. That more than counterbalances the use of the web for promoting junk. It is a lot harder to keep a secret than it used to be.

There is an obituary of Lasantha Wickrematunge in the Sunday Leader, and a report from Amnesty International.